First off, quick intro. Hi y'all - I'm Gail, SAHM to Jack (21 months) and due with Gia in April. I frequent FSOT, but am diving in over here. Here's the scoop:

So it turns out the deal between my insurance company and my Drs office is that they can bill separately for an office visit ON TOP OF my global payment. I am paying $360, and that is supposed to cover all OB related office visits, u/s, and the Drs fee for delivering the baby. Then I also have $150 per night charge for staying in the hospital, which the baby falls under, unless she needs more than 2 nights. If she does, then it'll be $150 per night for her as well, capping out at a maximum of $1000 per person. (god forbid the same situation happens like it did with Jack where I was in the hospital for 3 days prior to me having him.)

I am talking to the billing department right now, (I'm on hold) and she said the Dr. filed for an office visit because he had to go "in depth" during one of my appointments, and that them going "in depth" isn't covered by my global payment, hence the additional $35 copay. They have the option of doing this at EVERY visit! So every $70 a month in copays until the end of the pregnancy, and then it'll be $35 a week! WTH! I'm sorry, but its the JOB of a doctor to make sure there aren't any issues or concerns with their patients, and if there are - its their job to rectify them.

THEN I mentioned that last week I waited for over 2 hours to be seen by the Dr, and when he finally DID make an appearance, he told me that he had "unexpected things come up". The billing lady said I wasn't on his schedule to be seen, I was on the NP's schedule. Due to me being in L&D in December, I can't see a NP, I have to see a Dr. So the billing lady said that they probably didn't move me to his schedule until a week after I called. I CALLED 4 WEEKS IN ADVANCE, and they want ME to pay an additional copay for it!

All it is is his way of trying to get an extra payment - because not only does the insurance company pay him, but so do I. I haven't had any issues (thus far) with the other two Drs. in the practice. I am going to fight this tooth and freaking nail, because it isn't right.

And what sucks is that I can't do a damn thing about it. I can't move Drs. If I did leave the practice and went somewhere else, they could bill me for every office visit, and we sure as heck can't afford to pay $35 a whack, PLUS $35 for every u/s I've had. Then I'd still owe the new Dr. the global payment in less than 8 weeks, and a lot of Drs. (if not most) won't take a new patient in the last trimester. (which I hit in a week.)

momma so sorry you are going through that right now. How crappy of your doc to do that! I would be pissed too. Hopefully the insurance will make them change it or they will just change it on thier own. Good luck.